Twenty Million older citizens will become eligible for health benefits under Medicare next July 1. Before the new system, provided for by the Social Security Amendments of 1965, goes into effect, a multitude of arrangements have to be worked out between the federal government and the doctors, nurses, hospitals, nursing homes, insurance companies, health plan organizations, and state and other agencies that will be involved in the vast undertaking.

Because Medicare constitutes a momentous first step by the United States into the controversial field of compulsory health insurance, the rules and procedures now devised will be important precedent-setters. They will influence the quantity, quality, and cost of health care that will become available under this program for the elderly. And to that extent they may help to determine whether—or how soon—the nation will move toward compulsory health insurance for all.

Even at the present early stage, the impact of Medicare is reaching well beyond the 10 per cent of the population for whom it was devised. It has occasioned wholesale revisions of health insurance offerings to younger age groups and has led to new demands by organized labor in collective bargaining. More far-reaching will be Medicare's ultimate effect on medical care itself. The program's emphasis on community health planning, on the use of a variety of medical facilities, and on teamwork between medical and non-medical personnel is certain to bring important changes in the organization of services for care of the ill in all segments of the population.